A randomized trial of mailed HPV self-sampling for cervical cancer screening among ethnic minority women in South Florida
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HPV self-sampling has previously been shown to increase cervical cancer screening among ethnic minority and immigrant women. We conducted a randomized pragmatic trial to examine the effectiveness of HPV self-sampling delivered via in-person versus by US mail for medically underserved Hispanic, Haitian, and non-Hispanic Black women living in South Florida.
We randomized women aged 30–65 who had not completed Pap smear screening in the past 3 years into two groups: (1) HPV self-sampling delivered in-person (IP) by a community health worker (CHW; IP + SS) or (2) HPV self-sampling delivered via US mail (SS + Mail). Our primary outcome was HPV self-sampling completion by 6-month post-study enrollment.
We enrolled 600 women. Approximately 65% were Hispanic and 35% were Haitian or non-Hispanic Black. Nearly half (43%) had an income of less than $20,000/year and 67% were uninsured. In intent-to-treat analyses, 71.6% of participants in the SS + Mail group and 81.0% of participants in the IP + SS group completed HPV self-sampling.
Mailed HPV self-sampling is an effective strategy to increase cervical cancer screening among underserved immigrant and ethnic minority women.
KeywordsCervical cancer screening HPV Immigrant Women Self-sampling
We wish to thank our study team who played a critical role in ensuring completion of the study. These include our Community Health Workers, Valentine Cesar (Center for Haitian Studies), Maria Azqueta (Citrus Health Inc.), and Linabell Lopez (Community Health Inc.), our Health Choice Network (HCN) Project Manager, Ludmilla Paul, as well as, our data managers Carmen Linarte and Feng Miao.
This work was supported by the National Cancer Institute (1R01CA183612).
Compliance with ethical standards
Conflict of interest
The authors have no potential conflict of interest to disclose.
All procedures performed in our study were in accordance with the ethical standards of our institutional review board and with the 1964 Helsinki declaration and its later amendments.
Informed consent was obtained from all individual participants included in the study.
- 1.U.S. Cancer Statistics Working Group (2016) United States Cancer Statistics: 1999–2013 incidence and mortality web-based report. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention and National Cancer Institute. http://www.cdc.gov/uscs. Accessed 12 Jan 2017
- 7.Florida Cancer Data System (2014) http://fcds.med.miami.edu/inc/welcome.shtml. Accessed 26 June 2017
- 8.Centers for Disease Control and Prevention. National Program of Cancer Registries (NPCR). http://www.cdc.gov/cancer/npcr/tools.htm. Accessed 26 June 2017
- 11.Verdoodt F, Jentschke M, Hillemanns P, Racey CS, Snijders PJ, Arbyn M (2015) Reaching women who do not participate in the regular cervical cancer screening program by offering self-sampling kits: a systematic review and meta-analysis of randomized trials. Eur J Cancer 51:2375–2385CrossRefPubMedGoogle Scholar
- 14.Huh WK, Ault KA, Chelmow D et al (2015) Use of primary high-risk human papillomavirus testing for cervical cancer screening: interim clinical guidance. Gynecol Oncol. https://doi.org/10.1016/j.ygyno.2014.12.022
- 19.Obama B (January 12th 2017) Statement by the President on Cuban Immigration Policy. The White House. Retrieved 26 June 2017. https://obamawhitehouse.archives.gov/the-press-office/2017/01/12/statement-president-cuban-immigration-policy